Home > Journals > The Journal of Cardiovascular Surgery > Past Issues > The Journal of Cardiovascular Surgery 2001 October;42(5) > The Journal of Cardiovascular Surgery 2001 October;42(5):595-9

CURRENT ISSUE
 

JOURNAL TOOLS

eTOC
To subscribe PROMO
Submit an article
Recommend to your librarian
 

ARTICLE TOOLS

Reprints
Permissions

 

ORIGINAL ARTICLES  CARDIAC SECTION 

The Journal of Cardiovascular Surgery 2001 October;42(5):595-9

Copyright © 2009 EDIZIONI MINERVA MEDICA

language: English

Preoperative disseminated intravascular coagulation associated with aortic aneurysms

Sasaki S., Fukada Y., Kunihara T., Shiiya N., Matsui Y., Yasuda K.

From the Department of Cardiovascular Surgery Hokkaido University School of Medicine, Sapporo, Japan


PDF


Back­ground. To ­report clin­ical expe­ri­ences ­with dis­sem­i­nated intra­vas­cular coag­u­la­tion (DIC) asso­ciated ­with ­aortic aneu­rysms (AA) and dis­cuss ther­a­peutic ­strategy.
­Methods. ­Design and set­ting: uncon­trolled, obser­va­tional ­study in a uni­ver­sity hos­pital. ­Patients: ­among 547 ­patients ­with AA ­treated ­between 1991 and 1999, 10 ­patients (7 ­males, 3 ­females, ­mean age 68.5±2.5) pre­senting a pre­op­er­a­tive DIC ­score (­defined by the Min­istry of ­Health and Wel­fare in ­Japan) of 6 or ­higher ­were ana­lyzed. The eti­ology was dis­sec­tion for 5 and non-dis­sec­tion for 5 ­patients. Six of 10 ­patients had a ­bleeding ten­dency. ­Eight ­patients ­received pre­op­er­a­tive anti­co­ag­u­lant ­therapy. Pros­thetic replace­ment was under­taken for 8 ­patients ­except for 2 ­patients in ­poor con­di­tion.
­Results. ­There ­were no oper­a­tive ­deaths in 8 sur­gical ­cases. One non-sur­gical ­case ­died of dete­ri­orated ­bleeding ten­dency. The ­mean DIC ­score was 8.0±0.6 at admis­sion, ­which was ­reduced to 4.4±0.5 at dis­charge (p<0.05). Pro­thrombin ­time, ­platelet ­counts, and ­fibrinogen ­levels ­tended to be nor­mal­ized by the 7th post­op­er­a­tive day. ­Serum FDP ­levels ­decreased ­with sur­gery, but ­tended to ­increase at the ­time of dis­charge and the ­later ­follow-up ­period. Hemat­o­logic dis­tur­bances and ­bleeding ten­dency ­recurred in 2 ­patients in the ­follow-up ­period.
Con­clu­sions. In the ­majority of ­patients pre­senting DIC ­with ­aortic aneu­rysm, sur­gical treat­ment can be per­formed ­safely if ade­quately man­aged by anti­co­ag­u­lant ­therapy. Con­sump­tive coag­u­lop­athy usu­ally ­resolved ­after sur­gical inter­ven­tion, but ­some ­patients devel­oped DIC in the ­later ­period. If DIC ­recurs, it is essen­tial to ­search for con­trib­u­tory ­causes.

top of page